DESCRIPTION: This study aims to examine neck, shoulder, and back pain/disorders in registered nurses working in a variety of health care settings, using an anonymous mailed survey of 2000 nurses in two states. Specifically, this study will examine the relationship between musculoskeletal pain/disorders and physical work factors and the modifying (or potentiating) effect of organization of work (OOW) factors on this relationship. To estimate the effects of one industry-level factor, managed care penetration, nurses working in a state with limited managed care penetration will be compared to nurses in a state with high managed care penetration. Individual level indicators of changes in the work environment will also be collected. In addition, this study will document the prevalence of a number of specific preventive initiatives and control strategies associated with a reduction in work-related musculoskeletal disorders (MSDs) in this industry. To examine these issues, we have designated the following specific aims: (1) To determine the incidence and prevalence of work-related neck, shoulder, and back pain/disorders in registered nurses working in a variety of settings; (2) To determine physical work factors for neck and shoulder pain/disorders in registered nurses; (3) To examine the modifying (or potentiating) effect of work organization variables, including managed care penetration, staffing, job strain, and work schedules, on the relation between physical work factors and neck, shoulder and back pain/disorders; (4) To determine the availability and use of workplace prevention initiatives and control measures such as patient handling devices, lifting teams and worker participation, and their relationship to MSD among nurses working in a variety of settings; and (5) To determine the prevalence of safety incentive programs and their impact on reporting work-related MSD in a variety of health care organizations. Multiple logistic regression will be used to analyze Aims 1-4, with descriptive analyses for Aim 5, as appropriate. By including physical, OOW, and prevention factors in this study, we will generate results that can be used in practice, to reduce the prevalence and severity of MSD.